Pa. Code 5100.87

Extended involuntary emergency treatment not to exceed 20 days

This regulation governs the process for extending involuntary emergency psychiatric treatment beyond the initial 120-hour period, up to 20 days. Within 72 hours of initiating emergency involuntary treatment, the treating facility must reassess the individual and determine whether extended treatment is needed, which may take the form of inpatient, partial hospitalization, or outpatient modalities. If extension is warranted, the facility must notify the individual of their legal rights, file the required court application (Form MH-784), and present relevant clinical information at an informal judicial conference. The facility must also ensure the least restrictive appropriate treatment setting is used, including facilitating transfer to voluntary or community-based care if involuntary treatment is no longer necessary.

55 Pa. Code § 5100.87 - Extended involuntary emergency treatment not to exceed 20 days 

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(a)
 Within 72 hours
 after initiation of emergency involuntary treatment, the treating facility
 shall reassess the mental condition of the individual receiving treatment and
 shall determine whether the need for involuntary emergency treatment is likely
 to extend beyond the initial 120 hours.

(b)
 Extended involuntary emergency treatment
 may include inpatient, partial hospitalization, outpatient or a combination of
 treatment modalities. In determining whether to extend the emergency
 involuntary treatment, the treatment team shall consider: 
 
(1)
 The need for involuntary
 commitment.

(2)
 The optimal
 modality or setting for continued treatment.

(c)
 If the facility determines that extended
 emergency involuntary treatment is necessary, the facility shall: 
 
(1)
 Immediately notify the person that an
 application for extended involuntary treatment will be filed and that the court
 will appoint an attorney to represent the person unless it appears that the
 person can afford and desires to have private representation.

(2)
 Immediately deliver an application upon
 Form MH-784 to the court or Mental Health Review Officer through the
 administrator's office. Alternatively, any responsible person who has been
 involved in the emergency commitment process may act as petitioner.
 Applications need not be filed with or docketed by the prothonotary where the
 court so approves. If necessary, the court will appoint counsel for the
 patient.

(3)
 Immediately deliver an
 application upon Form MH-784 to the person subject to the proceedings and
 notify the parties identified by the person.

(d)
 Informal conference. The treatment
 facility shall present to the judge or mental health review officer all
 information it considers reliable and relevant to the determination as to
 whether the person is severely mentally disabled and in need of emergency
 treatment. The conference shall be informal, but conducted with decorum.
 Relevant information includes:
(1)
 Evidence of
 a person's conduct upon which a determination of mental disability may be
 based. If the alleged conduct constituting clear and present danger has
 occurred within 30 days relevant conduct prior to the 30 day period may be
 presented:

(2)
 The reasons why
 extended involuntary treatment is considered necessary.

(3)
 A description of the treatment to be
 provided.

(4)
 An explanation of the
 adequacy and appropriateness of such treatment for the individual, including
 why such treatment poses the least restrictive alternative for the
 individual.

(5)
 Any other relevant
 information even if it would be normally excluded under rules of evidence may
 be offered to the judge or mental health review officer who will review such
 information if he or she believes it is reliable. Only in rare instances need a
 stenographic record be taken of the proceedings required under this
 section.

(e)
 Certification
 for extended emergency involuntary treatment. 
 
(1)
 Certification for extended emergency
 involuntary treatment shall be made in writing on Form MH-784, issued by the
 Department.

(2)
 A certification
 filed and served shall remain in effect notwithstanding a petition for review
 of the certification, unless otherwise ordered by the court.

(3)
 Descriptions of proposed treatment shall
 be considered advisory only and shall be changed by the treatment team as the
 patient's condition warrants.

(f)
 The opportunity for a person on
 involuntary inpatient status to receive treatment in an approved less
 restrictive program such as involuntary partial hospitalization or outpatient
 services may be accomplished through a transfer under section 306 of the act
 (
50
 P. S. §
 
7306
). A commitment certification
 does not become void when a transfer from one program to another is
 executed.

(g)
 If the facility
 determines that extended emergency involuntary treatment is not necessary, it
 shall either accept the person for voluntary inpatient treatment or discharge
 the person and facilitate the person's obtaining: 
 
(1)
 Voluntary treatment at the facility best
 equipped to meet his needs.

(2)

 Report the person's change of status and follow-up recommendations by referral
 for continuity of care to the county administrator, or
 both.

Notes

55

 Pa. Code §
 
5100.87

This section cited in 55 Pa. Code §
 
5100.88
 (relating to court-ordered
 involuntary treatment not to exceed 90 days); 55 Pa. Code §
 
5100.89
 (relating to additional
 periods of court-ordered involuntary treatment not to exceed 180
 days).

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